Survival on the Heart Transplant Waiting List: Impact of Continuous Flow Left Ventricular Assist Device as Bridge to Transplant

ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012

“…598 More recent data suggest that patients with ongoing LVAD support may have an improved survival on the transplant waiting list. 599 Accordingly, MCS devices, particularly continuous-flow LVADs, are increasingly seen as an alternative to heart transplantation. Initially LVADs were developed for use as a short-term BTT approach (Table 13.1), 600 but they are now being used for months to years in patients who will either face a long-term wait on the transplant list (currently only 10% of patients with an MCS device implanted with a BTT indication will receive an organ within 1 year of listing) or in patients who are not eligible for transplantation as permanent therapy or destination therapy.…”

Current Practice in Patient Selecting for Long-Term Mechanical Circulatory Support

“…We are now seeing that patients with long-term support as a bridge to transplant have a longer survival to transplantation. Trivedi et al showed in a propensity match analysis that this survival at 1 year was 91 % in the LVAD group versus 77 % in the non-LVAD group [36].…”

Early Outcomes With Marginal Donor Hearts Compared With Left Ventricular Assist Device Support in Patients With Advanced Heart Failure

“…Heart transplantation remains the gold standard treatment for patients with ESHD; however, the supply of donor organs remains limited [2]. This limited supply of appropriate donor organs has led to the development and increased use left ventricular assist devices (LVADs) as bridge-totransplant (BTT) therapy [1][2][3][4].…”